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1992, 10-09 Permit App: 92008691 Mechanical FixturesJOB STRFRESS: CITY/STA i 'M J b PARCEL NUMBER: 4)/231 - L el.f) .l OWNER:.,,. E J * .€-"--I'- PHONE NUMBER: 9 2 1- 9§-G g MAILING SS: (Street) MECHANICAL PERMIT APPLICATION FORM Information Worksheet 4 f ,A3 C4u Alc CONTRAS MAILING +SSS: D ION ELECTRI WO00$`4 TER GAS WAIMFA. :: <100 000: TU (1NCLUDI GAS EQl1T+100,000 BTU DUCTWORK) TIi -100M BTU (City/State) LICENSE NUMBER: Co- H O.r"1` Z -go PHONE NUMBER: ¶?-1 -cL.21 E I( it, )40,i Cct t9.06, (Street) (City/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE ORK (SEPARATE SYSTEMS) �AS;PII BOILER/ 'PC?IL1 BOILER/ BOILER!, .........:....:..:... BOILER/ 501-1,000M BTU 1::;4001-1,75OI++1: E +1 750M BTU DNOITION:ER HEAT P CONDITIONER 3-15 TONS HEAT i oND ION:ER 5-30 T HEAT pugpaIR CONDITIONER 30-50 TONS ::..........::..�:..............::.;.::_ HEA ` P: ..;;IR CONDITIONER:+50 TONS ::....:::..::.......... ANS • VENTI LA TYPE' Ht, ,'' ER 12' OR 12' PTN. OF HOO CLOTH EVILER GAS LOG MISGEL: SNOT COVE ED ELSi=WH1= UNLISTE60 APPLIANCE <400,000 BTU #JLIN STE `APPLIAN.0 >400 --- USED 0BUSED APPOCE <400,000 BTU :USED A. >:.. >::::E 0=..1... U AIR HANDL 10,000 CFM AIR HAW' NOTE: MOM PERMIT FEE IS $35.00 SIGNATU NUMBER OF UNITS X EACH UNIT = AMOUNT x 10.00 = x 25.00 = x10.00 = 1 /©`£' ! x 12.00 = x15.00 = x 1.00 = x 12.00 = x 20.00 = x 25.00 = x35.00 = x 60.00 = x12.00 = `).-` a got vie (-1dO x 20.00 = x25.00 = x 35.00 = x 60.00 = x 10.00 = x 10.00 = x 50.00 = x10.00 = x 10.00 = x1000 = x 10.00 = x10.00 = x 50.00 = x100.00 = x 50.00 = x100.00 = x 12.00 = x 15.00 = SUBTOTAL $ .34"k PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT FEE DUE = $ il#1). Spokane County Division of Buildings .A, -_L 4 Ann %A/A nonan /con\ A CQ 4Q7G / u� '